Tria Triumph #132

Today’s #TriaTriumph truly highlights how Tria Health’s pharmacists will go above and beyond for our members.

A member’s child was suffering from severe plaque psoriasis and desperately needed treatment and medication. However, for several weeks, they were having unknown insurance and claim processing issues and were unable to receive the necessary medication/treatment. The patient reached out to their insurance, specialty pharmacy, and prescribing physician for answers, but she left each conversation without answers, confused, and frustrated. 

Our Tria Health pharmacist understood their frustration and concern and set out on a lengthy journey to solve the problem. First, she contacted the specialty pharmacy and was redirected several times. Eventually they told her to contact another department. The next day, she called again and demanded to talk with a clinician so that she could explain the issues and push for a solution. Our pharmacist was put on hold for over an hour! In the end, they discovered that the prior authorization was approved incorrectly because the starter dose was not included.

The prescription was rewritten which allowed the prior authorization to be inputted correctly. The pharmacy filled the medication and quickly prepared it to be shipped to the patient.

Thanks to the additional effort our Tria Health pharmacist, the endless cycle of confusing phone calls were resolved. The member was incredibly grateful they were able to find someone to listen to them and find a solution. At #TriaHealth we guarantee that our pharmacists will be devoted to your situation and in getting the answers that you deserve.